Membership Form

NATIONAL ORGANIZATION OF
INSURANCE OFFICERS
NORTHERN ZONE
(Affiliated to B.M.S.) (Regd No.4959)
Zonal Headquarters: B-3/37, Sector-18, Rohini,Delhi-110085.
Headquarters: 3 AB Hashim bldg., 40, Veer Nariman Marg, Hutatma Chowk, Mumbai 400001.

The General Secretary,
NOINO, NORTHERN ZONE,
New Delhi.
Dear Sir,
Please enroll me as a member of NOINO, NORTHERN ZONE.
I remit herewith Rs.____________being Entrance Fee* and the subscription for the months from______________to______________.
Place___________________ Yours faithfully,
Date____________________

Name:Shri/Smt./Kum.________________________________________________
Date of joining cadre____________________
Date of confirmation_____________________
Designation________________Department/Branch_____________________
S.R.No._______________ Division_________________________________
Date of Birth__________________Qualifications________________________
Telephone no.:-Residential_________________Mobile__________________
Office____________________
Residential Address__________________________________________________
________________________________________________________________________
e-mail address__________________________________
*Entrance Fee : Rs. 5.00
Subscription : Rs 200.00 (Yearly)
(For office use only)
Membership No._________________ Admitted__________________

Treasurer General Secretary